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Newborn Umbilical Cord Blood Banking and Donation: AAP Policy Explained

​​By: Mitchell S. Cairo, MD, FAAP & Allyson Flower, MD

Many parents have questions about umbilical cord blood banking and donation. 

The American Academy of Pediatrics policy statement, "Cord Blood Banking for Potential Future Transplantation" calls for renewed emphasis and education about the advantages and need for public cord blood banking.

Stem Cell Transplants

A stem cell transplant can be used to treat children with cancer and other life-threatening diseases including metabolic, immune, and blood disorders. As more newborns are screened for potentially fatal diseases, the number of stem cell transplants has increased as well. Using cord blood for stem cell transplants instead of bone marrow or peripheral blood stem cells is less invasive and expands the number of possible donors. The primary purpose of storing cord blood is so that a child with a potentially fatal disease can receive the banked cord blood from an unrelated matched donor.

Other uses of stored cord blood include:

  • Directed donation: When a child with a known disorder has a matched sibling donor. Upon delivery, the newborn sibling's cord blood can be stored and later used for a stem cell transplant.

  • Personal use: The use of a child's own banked cord blood is limited. For example, if a child develops leukemia, that child's stored cord blood will likely have the potential to progress to leukemia and cannot be used. Although the future use of a child's own banked cord blood for regenerative purposes in some chronic diseases is promising, further research is needed.

Public vs. Private Banking

There is a difference between public cord blood banks and private, for-profit cord blood banks.

Public cord blood banking is preferred, here's why:

  • Frequency of use: Cord blood from public blood banks is used more often than privately banked cord blood. Thirty times more publicly banked cord blood units are used for transplants compared to privately banked cord blood.

  • Quality: Collection, evaluation and preservation of publicly banked cord blood is highly regulated by accrediting institutions such as the NetCord/Foundation for Accreditation of Cell Therapy, the FACT/Joint Accreditation Committee, and the American Association of Blood Banks. Private cord blood banks may or may not choose to meet these standards. This is why publicly stored cord blood has been shown to be of higher quality—increasing the potential for a successful stem cell transplant. Parents who are thinking about private cord blood banking are encouraged to ask these facilities about accreditation, costs, failure rates of their stored cord blood to achieve successful transplantation, and method of backup electrical systems in case of storage equipment failure. Conflicts of interest and financial disclosures should be provided.

  • Cost: There is no cost to the donor family with public cord blood banking. Private cord blood banking requires a processing fee of $1350-$2350 and an annual maintenance fee of $100-175.

  • Ethical considerations: Publicly banked cord blood is available to anyone. National and international public cord blood banks are searchable for children with life-threatening diseases throughout the world who need a stem cell donor. Private banking serves the needs of only one family.

Closing the Diversity Gap

Ethnic minorities are encouraged to consider public cord blood donation, as the need is great. Public donation is free and builds up the supply of cord blood that can then serve the needs of others in these populations.

How You Can Donate to a Public Cord Blood Bank

Donating cord blood is safe for the baby and doesn't interfere with labor and delivery. Because families must register ahead of time—so a collection kit can be sent and used after the baby is born—parents should talk about cord blood banking with your obstetrician, pediatrician, or other medical personnel at the first prenatal visit. Cord blood donation should be arranged by the 34th week of pregnancy.

Does every hospital collect cord blood for public donation?

  • No. There is legislation in some states to support more funding for public cord banking, which is usually recovered when a patient's insurance is billed for a transplant. Check if your hospital is on the Be the Match list of participating cord blood collection hospitals. The Parent's Guide to Cord Blood Foundation guide to USA Donation Hospitals includes additional donation programs that may not be listed with Be the Match.

If my hospital doesn't work with a public cord bank, can I still donate?

  • If the hospital where you plan to have your baby does not work directly with a public cord blood bank, you can still donate by enrolling in a mail-in donation program. The Parent's Guide to Cord Blood lists public banks that accept cord blood donations by mail. Talk with your doctor or midwife to make sure he or she is trained to collect the cord blood.

Additional Information & Resources:


About Dr. Cairo:

Mitchell S. Cairo, MD, FAAP, is an expert pediatric hematologist-oncologist-stem cell transplantation physician at Maria Fareri Children's Hospital and a Professor of Pediatrics, Medicine, Pathology, Microbiology & Immunology and Cell Biology & Anatomy at New York Medical College. Within the American Academy of Pediatrics, he serves on the Committee on Pediatric Research and is a member of both the Section on Advances in Therapeutics and Technology and the Section on Hematology/Oncology. Dr. Cairo and his wife have raised two sons.

About Dr. Flower:

Allyson Flower, MD, is a pediatric hematologist-oncologist-stem cell transplantation physician at Maria Fareri Children's Hospital and an Assistant Professor of Pediatrics and Microbiology & Immunology at New York Medical College.




Last Updated
10/30/2017
Source
Section on Hematology/Oncology (SOHO) (Copyright © 2017 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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